Department of Orthopaedic Surgery, Friedrich-Schiller-University Jena at Rudolf-Elle-Hospital Eisenberg, Klosterlausnitzer Str. 81, Eisenberg, Germany.
Int Orthop. 2011 Jul;35(7):995-1000. doi: 10.1007/s00264-010-1091-8. Epub 2010 Jul 22.
Deep-vein thrombosis (DVT) and pulmonary embolism (PE) represent life-threatening postoperative complications frequently responsible for in-hospital mortality following total knee arthroplasty (TKA). Mechanical prophylaxis in the form of a foot pump offers an alternative to pharmacological and physical therapy. The aim of this prospective and randomised study was to examine the clinical efficacy of the A-V Impulse (AVI) system in reduction of soft-tissue swelling of the lower limb following a TKA. A total of 80 patients undergoing cemented TKA between September 2005 and December 2006 were randomised into two groups of 40 patients (n¹ = 40, n² = 40) during the 16-month study period. All patients received a subcutaneous dose of low molecular weight heparin (LMWH) (Enoxaparin/Clexane® 40 mg) once daily beginning 24 hours prior to the operation. The mean age for the groups n¹ and n² were 68.93 and 68.15 years, respectively. The reduction of soft-tissue swelling in the n¹ group was significantly higher (p < 0.05) compared with n². Evaluation of body mass index (BMI) with regard to the average reduction of soft-tissue swelling showed no significant influence (p < 0.05). The better function of the operated knee in group AVI was a significant predictor for improved agility and mobility (p < 0.01). No complications were reported for the application of the AVI. No ultrasonographic evidence of DVT or PE was found in any of the 80 patients during the investigative time period of eight days. After three months, there was no evidence of a symptomatic DVT.
深静脉血栓形成（DVT）和肺栓塞（PE）是全膝关节置换术后（TKA）导致院内死亡的常见危及生命的术后并发症。以足泵为形式的机械预防为药物和物理治疗提供了替代方案。本前瞻性随机研究的目的是检查 A-V Impulse（AVI）系统在减少 TKA 后下肢软组织肿胀方面的临床疗效。在 16 个月的研究期间，共有 80 名接受骨水泥 TKA 的患者在 2005 年 9 月至 2006 年 12 月期间随机分为两组，每组 40 名患者（n¹ = 40，n² = 40）。所有患者均在手术前 24 小时内接受每日一次的皮下低分子肝素（LMWH）（依诺肝素/克赛® 40mg）。组 n¹和 n²的平均年龄分别为 68.93 岁和 68.15 岁。与 n²相比，n¹组的软组织肿胀减少量明显更高（p<0.05）。评估体重指数（BMI）对软组织肿胀平均减少量的影响时，未发现明显影响（p<0.05）。AVI 组膝关节的功能更好是提高敏捷性和机动性的显著预测因素（p<0.01）。在 8 天的研究期间，80 名患者中没有任何并发症报道。三个月后，没有症状性 DVT 的证据。
